Arta Medica (May 2021)
ACTUALITIES IN THE MODERN DIAGNOSTIC AND TREATMENT OF DISTAL BILIARY OBSTRUCTIONS COMPLICATED WITH OBSTRUCTIVE JAUNDICE. A REVIEW
Abstract
Objectives. The aim of the study was to analyze data regarding the modern diagnostic and treatment of distal biliary obstructions complicated with obstructive jaundice. Material and methods. Scientific publications, which present information on the modern methods of approach to the problem of non-tumoral obstructive jaundice were analyzed, the emphasis being on endoscopic retrograde cholangiopancreatography and endoscopic papillosphincterotomy. The following sources were used for searching: Google Scholar, PubMed and the Medical Scientific Library of the State University of Medicine and Pharmacy „Nicolae Testemiţanu” from the Republic of Moldova. Keywords used in the search were: „non-tumoral obstructive jaundice”, „endoscopic retrograde cholangiopancreatography”, „endoscopic sphincterotomy”. Results. During search, 45 scientific publications were identified that report current information on the modern diagnostic and treatment of distal biliary obstructions complicated with obstructive jaundice. Conclusions. The endosurgical anatomy of the biliary tree has multiple anatomical variants, which must be considered in the process of performing various manipulations in this region. Their ignorance can lead to complications and intraoperative catastrophes. Despite the numerous and performant diagnostic possibilities, only endoscopic retrograde cholangiopancreatography is posted as a definitive or temporary diagnostic and curative maneuver in the treatment of non-tumoral obstructive jaundice. Endoscopic papillosphincterotomy, in combination with various endosurgical procedures (litextraction, stenting, etc.), allows for a temporary (as a preoperative preparation), or often permanent solution, of non-tumoral obstructive jaundice. Staged surgical tactics in the treatment of non-tumoral obstructive jaundice, in which the main role is attributed to endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy, allows for an efficient and safe treatment of the pathology.
